Biofilms May Prevent Healing in Diabetic Foot Ulcers

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For those living with diabetes, Diabetic foot ulcers (DFUs) can be a severe condition with tremendous economic and physical impacts on patients and their caregivers. However, one of the main reasons that DFUs are difficult to heal is likely related to the existence of biofilms.

What is a diabetic foot ulcer? Patients with diabetes have an increased risk of developing a foot sore, which is commonly called a diabetic ulcer. DFUs are responsible for a large majority of hospital admissions for patients with diabetes and can often be painless. It can take weeks or even months for a DFU to heal. Biofilms may create the perfect “protection” from antibiotics and other treatments to aid healing.

What are biofilms? Biofilms are a glue-like substance excreted by bacteria and/or fungi to attach to surfaces. Biofilm-forming infections can be difficult to heal because they protect and allow bacteria to survive and thrive in hostile environments. In fact, biofilms can make bacteria up to 1,000 times more resistant to antibiotics and antimicrobials.

Bacteria can remain dormant within the protection of the biofilm until they can break free, duplicate, and create a new infection and DFU symptoms. ⁠Biofilms are one of the main contributors to antibiotic resistance. The NIH estimates that 80% of all known human infections are associated with biofilms.⁠

Biofilms play an integral role in DFUs as it enables the disease to progress, develop resistance to antibiotics, and make the wound difficult to heal.

The Real Cost of Diabetes infographic provided by the American Podiatric Medical Association (APMA) estimates that the annual burden for diabetic foot ulcers in the US is $15 billion. Up to 25% of patients with diabetes will develop a foot ulcer in their lifetime, so there is a critical need for new technologies to help treat DFUs.

Image credit – American Podiatric Medical Association (APMA)

According to, there are several important factors to consider for DFUs:

  • Diabetes and blood flow disease is the #1 cause of foot/leg amputation in the US.
  • If untreated, some patients who develop a full ulcer can progress to amputation. Those people with diabetes who do receive amputation are almost always preceded by diabetic foot ulceration.
  • Studies show that specific populations and backgrounds are more likely to develop an ulcer. The single most common demographic is older men. This includes Native American, Hispanic, and African-American populations.
  • Patients who are advanced diabetics who need to use insulin are at the highest risk of developing a full ulcer. This is especially true if you have diabetes-related issues like kidney, eye, and heart disease.
  • The two biggest associated health conditions of being a diabetic are smoking and the use of alcohol.
  • Diabetic foot ulcers almost always start with diabetic foot infections.

Biofilms are now understood to play an essential role in recurrent DFIs and perhaps a larger role in why up to 25% of diabetic patients in the US will develop a DFU.

Learn more about biofilms and why Kane Biotech is THE Biofilm Company. With 74 patents and patents pending, Kane is leading the advancement of technologies and products that break up biofilms and destroy bacteria. Biofilms | Kane Biotech

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